HomeMy WebLinkAboutContract 62509-CA1CSC No. 62509-CA1
CITY OF FORT WORTH
ASSIGNMENT
For value received The Cleaning Guys, LLC ("Assignor"), hereby assigns to
EnviroServe, Inc. ("Assignee"), all of its right, title and interest in and to any and all sums of
money now due or to become due from the City of Fort. Worth to Assignor under CSCO 62509
(the "Contracts") and Assignee agrees to assume and perform all duties and obligations required
by Assignor under the terms of the Contracts.
This Assignment constitutes the entire agreement between Assignor and Assignee with
respect to the subject matter hereof. No modification of any provision of this Assignment shall
be effective unless in writing and signed by Assignor and Assignee. This Assignment shall inure
to the benefit of and be binding upon Assignor and Assignee and their respective successors and
assigns. This Assignment shall be governed by the terms of the original Contracts between
Assignor and various other entities and the City of Fort Worth and the laws of the State of Texas,
without application of principles of conflicts of law.
This Assignment may be executed in one or more counterparts each of which shall be
deemed an original but all of which together shall constitute one and the same instrument.
Signed signature pages may be transmitted by facsimile or e-mail, and any such signature shall
have the same legal effect as an original.
Dated the 11�^ day of NO (((-/tn 2025.
The Cleaning Guys, LLC
(Assignor) Q
By:
Print: Mike, tAG,6�,d_L
Title: Chief Operating Officer
EnviroServe, Inc.
(Assignee)
By:
Print: ( a-ft- 9,vb m�ie_d
Title: Chief Financial Officer
OFFICIAL RECORD
CITY SECRETARY
FT. WORTH, TX
Assignment Page 1 of 3
NOTARY ACKNOWLEDGEMENT
On the W111 day of M Ci iuv--� 2025, personally appeared
MLkt Vc Pb d-Q- , who acknowledged to me that (s)he is the Chief Operating Officer of The
CIeaning Guys, LLC ("Assignor"), and that (s)he executed this document for the purposes and
consideration contained herein.
The Cleaning GU Lt
By: r
Print: Mike HCFbrr�
Title: Chief Operating Officer
SUBSCRIBED TO before me on this day of f4(q TCtr-� , 2025.
SHELSIE tARSEN
Notary Pie
0 Stale of Utah
tiny Commission Expires 02A3412026
Carmks m Number 722870
N to PublVnndfor the State of 0 t-a k
My commisres:
NOTARY ACKNOWLEDGEMENT
On the Vt1111 day of Ma Y ` V 1 2025, personally appeared
Mat 13 o MmRe tb( , who acknowledged to me that (s)he is the Chief Financial Officer of
EnviroServe, Inc. ("Assignee"), and that (s)he executed this document for the purposes and
consideration contained herein.
SUBSCRIBED TO before me on this
SHELSIE tARSEN
Notary Pubk
State Of Utah
My Commission Expires tYll'0OOS
Camnussion Number 722870
EnviroServe, Inc.
By: �"411
Print: Ma w (&bo md
Title: Chief Financial Officer
VA day of W f Clk , 2025.
a -y Pu lienand for the State of l )tci,b,
Comm ion Expires: ?—&
Assignment Page 2 of
CONSENT TO ASSIGNMENT
The City of Fort Worth consents to the assignment of The Cleaning Guys, LLC
("Assignor") to EnviroServe, Inc. ("Assignee"), of all its rights, title, and obligation owing and
all funds due or to become due to Assignor under CSCO 62509 as long as all terms required of
Assignor in said contracts are met by Assignee.
CITY OF FORT WORTH
Rob& Al' (dredge Nav 14, 202515:30 CDT)
Department Director
William Johnson (MAy 15, 202510:45 CDT)
Assistant City Manager
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ATTESTED BY:
Jannette Goodall, City Secretary
APPROVED AS TO FORM AND LEGALITY:
i
City of Fort Worth Assistant City Attorney
Contract Compliance Manager:
05/14/2025
Date
05/15/2025
Date
Date
By signing I acknowledge that I am the person responsible
for the monitoring and administration of this contract, including ensuring all performance and
reporting requirements.
Employee Signature/Date
Administrative Services Manager
Title
OFFICIAL RECORD
CITY SECRETARY
FT. WORTH, TX
Assignment Page 3 of
Form
Request for Taxpayer Give form to the
(Rev. March 2024) Identification Number and Certification requester. Do not
Department of the Treasury Go to www.irs.gov/For7nW9 for instructions and the latest information. Send to the IRS.
Internal Revenue Service
Before you begin. For guidance related to the purpose of Form W-9, see Purpose of Form, below.
1 Name of entity/individual. An entry is required. (For a sole proprietor or disregarded entity, enter the owner's name on line 1, and enter the business/disregarded
entity's name on line 2.)
EnviroServe, Inc.
2 Business name/disregarded entity name, if different from above.
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3a Check the appropriate box for federal tax classification of the entity/individual whose name is entered on line 1. Check
4 Exemptions (codes apply only to
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only one of the following seven boxes.
certain entities, not individuals;
a
c
❑ Individual/sole proprietor ❑✓ C corporation ❑ S corporation ❑ Partnership ❑ Trust/estate
see instructions on page 3):
0
C
❑ LLC. Enter the tax classification (C = C corporation, S = S corporation, P = Partnership) . . . .
Exempt payee code (if any)
a O
Note: Check the "LLC" box above and, in the entry space, enter the appropriate code (C, S, or P) for the tax
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classification of the LLC, unless it is a disregarded entity. A disregarded entity should instead check the appropriate
Exemption from Foreign Account Tax
O
"
box for the tax classification of its owner.
Compliance Act (FATCA) reporting
w
El Other (see instructions)
code (if any)
au
y=
3b If on line 3a you checked "Partnership" or "Trust/estate," or checked "LLC" and entered "P" as its tax classification,
(Applies to accounts maintained
and you are providing this form to a partnership, trust, or estate in which you have an ownership interest, check
the United States.)
Hthis
box if you have any foreign partners, owners, or beneficiaries. See instructions . . Eloutside
CD5 Address (number, street, and apt. or suite no.). See instructions.
I9815 South Monroe Street, Suite 300
6 City, state, and ZIP code
Sandy, UT 84070
7 List account number(s) here (optional)
Taxpayer Identification Number (TIN)
Requester's name and address (optional)
Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid Social security number
backup withholding. For individuals, this is generally your social security number (SSN). However, for a
resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other - -
entities, it is your employer identification number (EIN). If you do not have a number, see How to get a or
TIN, later.
� Employer identification number
Note: If the account is in more than one name, see the instructions for line 1. See also What Name and
Number To Give the Requester for guidelines on whose number to enter. M34 - 11 16 13 19 15 12 16
LiM Certification
Under penalties of perjury, I certify that:
1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and
2. 1 am not subject to backup withholding because (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue
Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am
no longer subject to backup withholding; and
3. 1 am a U.S. citizen or other U.S. person (defined below); and
4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct.
Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding
because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid,
acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and, generally, payments
other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the instructions for Part 11, later.
Sign Signature ; /
Here U.S. personn ��1� �Y
General Instructions
Section references are to the Internal Revenue Code unless otherwise
noted.
Future developments. For the latest information about developments
related to Form W-9 and its instructions, such as legislation enacted
after they were published, go to www.irs.gov/F6rmlN9.
What's New
Line 3a has been modified to clarify how a disregarded entity completes
this line. An LLC that is a disregarded entity should check the
appropriate box for the tax classification of its owner. Otherwise, it
should check the "LLC" box and enter its appropriate tax classification.
Date ////2-02-6-
New line 3b has been added to this form. A flow -through entity is
required to complete this line to indicate that it has direct or indirect
foreign partners, owners, or beneficiaries when it provides the Form W-9
to another flow -through entity in which it has an ownership interest. This
change is intended to provide a flow -through entity with information
regarding the status of its indirect foreign partners, owners, or
beneficiaries, so that it can satisfy any applicable reporting
requirements. For example, a partnership that has any indirect foreign
partners may be required to complete Schedules K-2 and K-3. See the
Partnership Instructions for Schedules K-2 and K-3 (Form 1065).
Purpose of Form
An individual or entity (Form W-9 requester) who is required to file an
information return with the IRS is giving you this form because they
Cat. No. 10231X Form W-9 (Rev. 3-2024)
UCC Business Organizations Trademarks Account Help/Fees Briefcase Lagout
Filing Number: 804017522 Entity Type: Foreign For -Profit Corporation
Original Date of Filing: April 8, 2021 Entity Status: In existence
Formation Date: N/A
Tax ID: 32070948784 FEIN: 341639526
Name: EnviroServe Inc.
Address: 7640 Whipple Ave. NW
North Canton; OH 44720 USA
Fictitious Name: NIA
Jurisdiction: OH, USA
Foreign Formation January 30, 1990
Date:
11 REGISTERED AGENT FILM FILSTO Y=
Name
G T Corporation System
Order I I Return to Search
BUSINESS ORGANIZATIONS INQUIRY - VIEW ENTIT
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Address
1999 Bryan St.. Ste. 900
Dallas. Tx 75201-3136 USA
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